title: Change in quality of life and predictors of change among patients with multiple sclerosis: a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to determine the changes in the health-related quality of life (HRQoL) and predictors of change among patients with multiple sclerosis (MS) at 3 and 6 years during the follow-up period.
  
  
  METHODS
  A group of 109 consecutive MS patients (McDonald's criteria) referred to the Clinic of Neurology, Belgrade, were enrolled in the study. At three time points during the study (baseline, and at 3 and 6 years during the follow-up period), the HRQoL (measured by MSQoL-54), Expanded Disability Status Scale, and Hamilton Rating Scale for Depression and Fatigue Severity Scale were assessed.
  
  
  RESULTS
  During the study period, 93 patients provided both follow-up assessments. Statistically significant deterioration in the HRQoL at each subsequent time point was detected for all scales of the MSQoL-54 except for the pain and change in health scales. A higher level of education was a significant prognostic factor for a better HRQoL on the cognitive function scale throughout the entire period of observation, while marital status (single, including divorced and widowed) and increased age at the onset of MS had significant predictive values of poorer quality-of-life scores on the overall quality-of-life scale at 6-year follow-up. Higher levels of physical disability and depression at baseline were statistically significant prognostic markers for deterioration in HRQoL for the majority of MSQoL-54 scales during the entire follow-up period.
  
  
  CONCLUSIONS
  Our study suggests that baseline demographic and clinical characteristics could be applied as prognostic markers of the HRQOL for patients diagnosed with MS.
authors.affiliation: Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia.
authors.forename: Darija Kisic
authors.initials: DK
authors.lastname: Tepavcevic
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekmezovic
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Stojsavljevic
authors.forename: Jelena
authors.initials: J
authors.lastname: Kostic
authors.forename: Irena Dujmovic
authors.initials: ID
authors.lastname: Basuroski
authors.forename: Sarlota
authors.initials: S
authors.lastname: Mesaros
authors.forename: Jelena
authors.initials: J
authors.lastname: Drulovic
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D005221:Fatigue / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000523:psychology*; D009460:Neurologic Examination; D011446:Prospective Studies; D011788:Quality of Life; D055771:Serbia; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult